The pirani score evaluation on patients with clubfoot treated with the ponsety method in public hospital


Background: Congenital talipes equinovarus (CTEV) or clubfoot refers to congenital anomalies in the feet with complex deformities. The non-surgical technique with the Ponseti method for clubfoot treatment has been adopted as initial therapy and proven effective for clubfoot treatment. Purpose: This study aims to evaluate the results of Ponseti therapy in patients with clubfoot who came to the Ponseti Clinic at the Dr. Soetomo Regional Public Hospital, Surabaya. Method: 14 patients consisting of nine men and five women were involved in the study. Based on the data obtained, ANOVA statistical test was performed on the Pirani score (total score), hindfoot score, and midfoot score. Furthermore, the statistical hypothesis testing was performed by comparing the degree of clubfoot severity with Pirani scores using the independent t-test. Results. The mean Pirani Score in the research subjects reached 1.178. The mean Hindfoot score of research subjects reached 0.5. The mean Midfoot Score of the Research Subject was 0.642. The statistical hypothesis testing results revealed that the mean Pirani Score in the degree of severity for the severe category was higher than the mean Pirani Score for the moderate category, which was statistically insignificant with a p-value of 0.126). Conclusion: Pirani score can be a reference as a clinical evaluation of patients with clubfoot who undertake conservative treatment with the Ponseti technique. Moreover, the Pirani score can also provide predictions of clubfoot severity.


  • Agarwal, A., & Gupta, N. (2014). Does initial Pirani score and age influence number of Ponseti casts in children?. International orthopaedics, 38(3), 569-572.
  • Changulani, M., Garg, N. K., Rajagopal, T. S., Bass, A., Nayagam, S. N., Sampath, J., & Bruce, C. E. (2006). Treatment of idiopathic club foot using the Ponseti method: initial experience. The Journal of bone and joint surgery. British volume, 88(10), 1385-1387.
  • Dyer, P. J., & Davis, N. (2006). The role of the Pirani scoring system in the management of club foot by the Ponseti method. The Journal of bone and joint surgery. British volume, 88(8), 1082-1084.
  • Herzenberg, J. E., Radler, C., & Bor, N. (2002). Ponseti versus traditional methods of casting for idiopathic clubfoot. Journal of Pediatric Orthopaedics, 22(4), 517-521.
  • Kelly, D (2017). Congenital Clubfoot (Talipes Equinovarus). In: Campbell’s Operative Orthopaedics. 13th ed. Azar F, Beaty J, Canale S, editors. Philadelpia: Elsevier; 1031-45 p.
  • Kusumaningrum, T., Kurnia, I. D., & Doka, Y. P. (2019, March). Factors Related to Mother’s Competency In Caring For Low Birth Weight Baby Based on Theory of Planned Behavior. In IOP Conference Series: Earth and Environmental Science (Vol. 246, No. 1, p. 012029). IOP Publishing.
  • Mejabi, J. O., Esan, O., Adegbehingbe, O. O., Orimolade, E. A., Asuquo, J., Badmus, H. D., & Anipole, A. O. (2016). The Pirani scoring system is effective in assessing severity and monitoring treatment of clubfeet in children. Journal of Advances in Medicine and Medical Research, 1-9.
  • Pavone, V., Bianca, S., Grosso, G., Pavone, P., Mistretta, A., Longo, M. R.,... & Sessa, G. (2012). Congenital talipes equinovarus: an epidemiological study in Sicily. Acta orthopaedica, 83(3), 294-298.
  • Pirani, S., Hodges, D., & Sekeramayi, F. (2008, March). A reliable & valid method of assessing the amount of deformity in the congenital clubfoot deformity. In Orthopaedic Proceedings (Vol. 90, No. SUPP_I, pp. 53-53). The British Editorial Society of Bone & Joint Surgery.
  • Ponseti, I. V., & Campos, J. (2009). The classic: observations on pathogenesis and treatment of congenital clubfoot. Clinical orthopaedics and related research, 467(5), 1124-1132.
  • Ponseti, I. V., & Smoley, E. N. (2009). The classic: congenital club foot: the results of treatment. Clinical orthopaedics and related research, 467(5), 1133-1145.
  • Ponseti, I. V., Cummings, R. J., Davidson, R. S., Armstrong, P. F., & Lehman, W. B. (2002). The ponseti technique for correction of congenital clubfoot. JBJS, 84(10), 1889-1891.
  • Ricco, A., Richards, B., Herring, J (2014). Tachdjian’s pediatric orthopaedics. 5th ed. Herring J, editor. Philadelpia: Elsevier; 785–818 p.
  • Sisay, T., Verma, D., Berhane, N., & Tsegaw, M. (2018). Vaccine Development Strategies, Progresses and Challenges for Human Immunodeficiency Virus (HIV): A Review. The International Journal of Biotechnology, 7(1), 8-16.
  • Wainwright, A. M., Auld, T., Benson, M. K., & Theologis, T. N. (2002). The classification of congenital talipes equinovarus. The Journal of Bone and Joint Surgery. British volume, 84(7), 1020-1024.
  • Zionts, L. E., Frost, N., Kim, R., Ebramzadeh, E., & Sangiorgio, S. N. (2012). Treatment of idiopathic clubfoot: experience with the Mitchell-Ponseti brace. Journal of Pediatric Orthopaedics, 32(7), 706-713.


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